How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,089.30 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,089.30 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $2,511.89 | Professional | None | $426.58 | $524.81 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,000.00 | Professional | None | $562.34 | $776.25 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $123.03 Typical High $162.18 | Professional | 80 · Assistant surgeon | $91.20 | $123.03 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $107.15 Typical High $141.25 | Professional | AS · PA/NP assist | $79.43 | $107.15 | $141.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $776.25 | Professional | None | $489.78 | $549.54 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,884.03 Typical High $3,801.89 | Facility | None | $912.01 | $2,884.03 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $1,348.96 | Professional | None | $524.81 | $645.65 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $812.83 Median $2,754.23 Typical High $26,302.68 | Facility | None | $812.83 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,380.38 Typical High $5,011.87 | Professional | None | $602.56 | $1,380.38 | $5,011.87 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,445.44 | Professional | None | $562.34 | $758.58 | $1,445.44 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $263.03 Typical High $269.15 | Professional | 52 · Reduced service | $213.80 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $104.71 Typical High $107.15 | Professional | 53 · Discontinued | $85.11 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $398.11 Typical High $407.38 | Professional | 54 · Surgery only | $316.23 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $79.43 Typical High $81.28 | Professional | 55 · Aftercare only | $63.10 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $52.48 Typical High $53.70 | Professional | 56 · Pre-op care only | $42.66 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $371.54 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $295.12 | $371.54 | $380.19 |
Where Missouri sits
The same service costs 8.3 times more in Oklahoma than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Missouri· 30th of 51
$794
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.